Nokea
A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.
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A patient is allergic to penicillin. Which class of antibiotics might they also have a cross-allergy to?
- A. Cephalosporins
- B. Sulfonamides
- C. Macrolides
- D. Aminoglycosides
- G. A
Correct Answer: Cephalosporins share a similar structure with penicillin, risking cross-allergy. Sulfonamides, macrolides, and aminoglycosides lack this relation.
Rationale: The correct answer is A: Cephalosporins. Cephalosporins have a beta-lactam ring structure similar to penicillin, leading to potential cross-allergy. Sulfonamides, macrolides, and aminoglycosides have different chemical structures, reducing the likelihood of cross-allergy. Therefore, individuals allergic to penicillin may have a cross-allergy to cephalosporins due to structural similarity, making it the correct choice.
Four patients are due to receive their morning insulin and breakfast will be served in 15 minutes. Which patient should the nurse administer insulin to first?
- A. The patient with a pre-meal glucose level of 90 mg/dL, scheduled to receive 10 units of NPH.
- B. The patient with a pre-meal glucose level of 70 mg/dL, scheduled to receive 2 units of aspart (Novolog) insulin.
- C. The patient with a pre-meal glucose level of 120 mg/dL, scheduled to receive 15 units of NPH.
- D. The patient with a pre-meal glucose level of 170 mg/dL, scheduled to receive 5 units of lispro (Humalog) insulin.
- G. D
Correct Answer: 90 mg/dL (NPH) and 70 mg/dL (aspart) are normal/low, less urgent. 120 mg/dL (NPH) is mildly high. 170 mg/dL with rapid-acting lispro needs priority due to significant elevation.
Rationale: The correct answer is D: The patient with a pre-meal glucose level of 170 mg/dL, scheduled to receive 5 units of lispro (Humalog) insulin. This choice is correct because a glucose level of 170 mg/dL is significantly elevated, indicating a need for immediate insulin administration to prevent further hyperglycemia. Lispro is a rapid-acting insulin, which should be administered promptly before breakfast to control the high blood sugar effectively. Choices A, B, and C have glucose levels within normal or slightly elevated ranges, making them less urgent for immediate insulin administration. Choice D is the most critical due to the high glucose level and the type of insulin being rapid-acting, requiring prompt action to manage the patient's blood sugar levels effectively.
In which of the following conditions should decongestants be used with caution?
- A. Diabetes
- B. Hypertension
- C. Allergic rhinitis
- D. Hyperthyroidism
- G. B
Correct Answer: Diabetes isn't a primary caution. Hypertension risks elevation from vasoconstriction. Allergic rhinitis is a treatment target. Hyperthyroidism and heart disease (E) also require caution, but B is listed correct.
Rationale: The correct answer is B: Hypertension. Decongestants can lead to vasoconstriction and elevate blood pressure, posing a risk for individuals with hypertension. Diabetes (A) is not a primary concern with decongestants. Allergic rhinitis (C) is a condition where decongestants are often used as a treatment. Hyperthyroidism (D) can have cardiovascular effects and should also be used with caution. However, the primary caution for decongestant use is hypertension due to the potential for exacerbating high blood pressure.
What is the priority action for a nurse caring for a client with a urinary tract infection before administering prescribed antibiotics?
- A. Obtain a blood pressure
- B. Obtain a urine specimen for culture and sensitivity
- C. Obtain a PTT
- D. Obtain a platelet count .
- G. B
Correct Answer: Blood pressure is routine, not priority. Urine culture identifies the bacteria and antibiotic sensitivity before treatment. PTT and platelet counts are unrelated to UTI antibiotics.
Rationale: The correct answer is B: Obtain a urine specimen for culture and sensitivity. This is the priority action because it helps identify the specific bacteria causing the UTI and determines the most effective antibiotic for treatment. This step is crucial for appropriate antibiotic therapy and to prevent antibiotic resistance. A: Obtaining a blood pressure is a routine assessment and not directly related to UTI treatment. C and D: Obtaining a PTT and platelet count are not necessary for assessing or treating a UTI; these tests are unrelated to UTI management. Therefore, the priority action for a nurse caring for a client with a UTI is to obtain a urine specimen for culture and sensitivity.
What would the nurse teach a client to avoid when taking barbiturates?
- A. Nicotine
- B. Alcohol
- C. Bananas
- D. Caffeine
- G. B
Correct Answer: Nicotine and caffeine don't critically interact. Alcohol, a CNS depressant, dangerously enhances barbiturate sedation. Bananas are unrelated.
Rationale: The correct answer is B: Alcohol. Barbiturates and alcohol are both central nervous system depressants, and when taken together, they can dangerously enhance sedation and respiratory depression. This can lead to overdose and even death. Nicotine (choice A) and caffeine (choice D) do not have critical interactions with barbiturates, so there is no specific teaching to avoid them. Bananas (choice C) are unrelated to barbiturate use and do not pose any risk. It is crucial for the nurse to educate the client on the dangers of combining barbiturates with alcohol to prevent adverse effects and ensure the client's safety.